MEDICARE: DR. MARK JERROLD SCHEFKIND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	0101043631	VA

General Provider Information

NPI Number	:	1972500650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK JERROLD SCHEFKIND M.D.

Provider Business Mailing Address
First Line	:	8101 HINSON FARM RD
Second Line	:	SUITE 103
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-3403
Country	:	US
Telephone Number	:	703-360-0111
Fax Number	:	703-799-1126

Provider Business Practice Location Address
First Line	:	8101 HINSON FARM RD
Second Line	:	SUITE 103
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-3403
Country	:	US
Telephone Number	:	703-360-0111
Fax Number	:	703-799-1126

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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